Organization
JLV1 LLC
Active
Other names
Advance Spine & Rehab Center
Organization subpart
No
Provider details
NPI number
Authorized official
LYNNETTE MCROY (BILLING COORDINATOR)
(773) 767-3822
Entity
Organization
Contact information
Practice address
3139 W 111TH ST, CHICAGO, IL 60655-2205
(773) 767-3822
(773) 337-9106
Mailing address
3139 W 111TH ST, CHICAGO, IL 60655-2205
(773) 767-3822
(773) 337-9106
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038011879
IL
Other
Enumeration date
05/10/2013
Last updated
05/10/2013
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